Dutka Julian, Sosin Paweł, Urban Mariusz, Libura Marek
Oddział Chirurgii Ortopedyczno-Urazowej, Szpital Specjalistyczny im. Stefana Zeromskiego w Krakowie.
Chir Narzadow Ruchu Ortop Pol. 2003;68(5):323-7.
128 hips after revision arthroplasty in 115 patients which had been operated in our Ward in 1990-2001 were retrospectively evaluated. There were 99 women and 16 men with mean age: 68.9 years old. The mean time of follow-up was 28.6 months (form 3 to 120 months). In 98 hips there were aseptic loosening of the both elements of the prosthesis, in 13 hips there were aseptic loosening of the stem, in 17 hips there were aseptic loosening of the cup only. Cement total hip rearthroplasty was made in 112 cases and cementless total hip rearthroplasty was made in 16 hips. In presented material there were used the acetabular bone grafts in 114 cases, and the femoral bone grafts in 97 cases--all with allogenic frozen bone grafts. The additional implants were used in 31 cases (meshwork, wire, screw). The bone defects in acetabulum and femoral stem was based on Paprovsky classification. There were good and excellent results in 90% and poor or bad results in 10% according to clinical and radiological evaluation. Mean clinical result was 78.5 p. in Harris Hip Score. The radiological results were poor in 13 hips (according to criterion proposed by joined committee of The Hip Society, SICOT and AAOS). Osteointegration of bone allografts was radiologically confirmed in 81% of cases. Complication rates is 20%. There is no correlation between the type of acetabular or femoral bone defects and results of revision hip arthroplasty. Poor results are correlated with use of SKT or Weller stem. Wagner femoral osteotomy and the lack of bone allografts healing.
对1990年至2001年在我们病房接受手术的115例患者的128髋翻修关节置换术后情况进行回顾性评估。其中女性99例,男性16例,平均年龄68.9岁。平均随访时间为28.6个月(3至120个月)。98髋假体的两个部件均发生无菌性松动,13髋仅假体柄发生无菌性松动,17髋仅髋臼发生无菌性松动。112例采用骨水泥型全髋关节置换术,16髋采用非骨水泥型全髋关节置换术。在本研究材料中,114例使用了髋臼植骨,97例使用了股骨植骨——均为同种异体冷冻骨移植。31例使用了额外的植入物(网片、钢丝、螺钉)。髋臼和股骨干的骨缺损根据Paprovsky分类。根据临床和影像学评估,90%的结果为良好和优秀,10%的结果为差或不良。Harris髋关节评分的平均临床结果为78.5分。13髋的影像学结果较差(根据髋关节协会、SICOT和AAOS联合委员会提出的标准)。81%的病例经影像学证实异体骨骨整合良好。并发症发生率为20%。髋臼或股骨骨缺损类型与髋关节翻修术结果之间无相关性。结果差与使用SKT或Weller柄、Wagner股骨截骨术以及异体骨未愈合有关。